Globally, cervical cancer is the fourth leading cause of cancer-related deaths among women. Over 85% of these deaths occur in developing regions. Aga Khan University’s (AKU) CITRIC Health Data Science Centre and Centre of Excellence in Women and Child Health hosted public and private sector experts in Islamabad for a seminar on cervical cancer in Pakistan.
Dr Faisal Sultan, Special Assistant to the Prime Minister on Health, attended as the event’s chief guest, while representatives from the healthcare systems in Pakistan, Gavi, and JHPiego also shared their expertise in the seminar. Participants estimate that low-and-middle-income countries (LMICs) will bear the majority of this disease burden in the near future.
Though cervical cancer is a preventable disease, the mortality rate is very high as it is an ignored ailment in Pakistan in terms of screening, prevention and vaccination. The Human Papilloma Virus (HPV) is the leading global factor which causes cervical cancer, for which there are highly effective vaccines but unfortunately, the uptake of these vaccines is very low in Pakistan.
“If we vaccinate 9 out of 10 girls before the age of 15, we will be on the way to eliminating cervical cancer. We need to educate the general public about HPV and cervical cancer, and their prevention, while mitigating any negative perceptions” shared Dr Sajid Bashir Soofi, Professor at the Department of Paediatrics and Child Health, and Associate Director at Centre of Excellence in Women and Child Health, AKU Medical College Pakistan.
AKU Medical College Pakistan’s faculty are conducting research to calculate the disease burden for cervical cancer through reviews into its reported incidence rates between 1995 - 2022. Disease burden estimates are important tools for making informed health policies to improve population health. “We need better data sharing and contribution from both public and private sectors, and more consistent surveillance over time to arrive at estimates of burden that can be then tracked over time for improvement” said Dr Zainab Samad, Chair of the Department of Medicine and Director of CITRIC Health Data Science Centre, AKU Medical College Pakistan.
Discussions during the event highlighted variation in the reported estimates of cervical cancer across Pakistan. Karachi Cancer Registry reported the highest incident rate over time, showing estimates well above the WHO 2030 target for cervical cancer elimination in all countries, which is 4 cases per 100,000 women annually.
“Emerging data from studies on single dose HPV regimens shows high efficacy, efficacy cross all age groups as 9-14 year old girls, as well as 15 to 20 year old and durable protection.”, said Dr. Peter Dull, Deputy Director, Vaccine Development and Surveillance, Bill & Melinda Gates Foundation.
In regards to equitable vaccine access, Dr. Anissa Sidibe Senior Program Manager HPV Vaccine, GAVI shared “In terms of HPV vaccine program that GAVI supports, what we’ve been doing with a lot of our partners and including the Gates Foundation is really looking at market shaping initiatives and making sure that the access to the price is accessible for our GAVI eligible countries so today we’ve been able to negotiate the price of the vaccine as low as $4.50 for the Gardasil, $5.18 for the Cervarix and as alluded there’s a new Chinese entrant from Innovax and that one is a $2. 90, so we can see that, compared to other high income countries, we’ve really been successful at ensuring that the price is adequate and affordable for our countries and we’re continuing to do this with new manufacturers in the pipeline between now and 2025”. Seminar participants also included Dr Mark Jit and Dr Kiesha Prem who are experts working on HPV vaccines from the London School of Hygiene.
Participants also discussed the complicated management of the disease as treatment for cervical cancer depends on several factors, such as the stage and type of cancer and other health problems.
“It will be an unacceptable public health failure if we continue to let women die from this largely preventable and treatable disease” - Dr Sajid Bashir Soofi.
